Multidisciplinary management of HCC improves therapy access, patient survival
Management of patients with hepatocellular carcinoma (HCC) through a multidisciplinary tumour board (MDTB) results in significantly higher rates of receipt of therapy and improved survival, according to a recent study.
Researchers conducted a database analysis of all patients with HCC managed through MDTB from 2007 until 2011 to determine and compare utilization of therapies and outcomes for HCC patients managed through MDTB with those who were not. They also created a database of all HCC patients from 2002 to 2011, not managed through MDTB.
There were 306 patients with HCC managed through MDTB from 2007 to 2011 compared with 349 from 2002 to 2011 who were not.
No significant differences were recorded in baseline demographic or model for end-stage liver disease at presentation. Patients managed through MDTB were associated with presentation at an earlier tumour stage and with lower serum alpha fetoprotein (AFP; p=0.007).
Patients managed through MDTB were more likely to receive any treatment for HCC (odds ratio, 2.80; 95 percent CI, 1.71 to 4.59; p<0.0001), independent of model for end-stage liver disease score, serum AFP and tumour stage. Also, patients managed through MDTB had significantly greater survival compared to those who were not (19.1±2.5 vs 7.6±0.9 months; p<0.0001).
Management through MDTB, receipt of any HCC treatment, lower serum AFP, receipt of liver transplant and T2 tumour stage were the independent predictors for improved survival.
“Given the complexity of managing [HCC], it is widely accepted that a multidisciplinary team approach (tumour boards) offers the best approach to individualize therapy,” according to researchers.